Case News

As of Tuesday July 31, 2018, the Delaware General Health District has received a total of 683 inquiries related to a possible foodborne illness outbreak stemming from the Chipotle located at 9733 Sawmill Parkway. Of those inquiries, staff members have completed over 480 interviews.

The Ohio Department of Health returned initial stool sample results today – all have tested negative for Salmonella, Shigella, E. coli and Norovirus. Further stool testing will be conducted for other pathogens. The food samples are still in the process of being tested for Bacillus Cereus or Clostridium Perfringens in addition to the four diseases listed above that are tested in stool samples.

The Delaware General Health District suggests that you please contact your local health department to file food complaints. Posting on social media and/or a website is not an official complaint. The Health District has also received calls regarding medical attention. Please consult your doctor for all medical needs.

Although, McDonalds is linked to nearly 300 illnesses, other illnesses may also be linked as recalls expand. NOTE – FDA and Fresh Express has not yet named other retailers where product was sold.

Fast Facts from the FDA:

The FDA, CDC, along with state and local officials are investigating a multi-state outbreak of cyclosporiasis illnesses likely linked to salads from McDonald’s restaurants.

On July 26, 2018, the FDA completed final analysis of an unused package of Fresh Express salad mix containing romaine lettuce and carrots, which had been distributed to McDonald’s. The analysis confirmed the presence of Cyclospora in that sample, though the expiration date for that product, July 19, had already passed. On July 27, the FDA informed Fresh Express of the results.

FDA instructed Fresh Express to determine whether potentially contaminated product may still be on the market. Fresh Express reported to FDA that the romaine from the same lot as the positive sample was not packaged for direct retail sale by Fresh Express and had already expired. Fresh Express committed to using recall procedures to inform those companies that received this romaine about the sample result. Fresh Express also reported that carrots used in the mix were only sent to McDonald’s locations.

On July 30, 2018, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) issued a public health alert on beef, pork and poultry salad and wrap products potentially contaminated with Cyclospora that were distributed by Caito Foods LLC, of Indianapolis, IN. The products were produced between July 15 and 18, 2018, with either “Best By,” “Enjoy by,” “Best if Sold By” or “Sell By” dates ranging from July 18 through July 23, 2018. Caito Foods had received notification from Fresh Express that the chopped romaine in these products was being recalled.

The CDC reports that 286 people in 15 states have become ill. There have been 11 hospitalizations and no deaths.

The investigation is ongoing and the FDA is currently reviewing distribution and supplier information for romaine and carrots.

As of July 13, 2018, McDonald’s decided to voluntarily stop selling salads at impacted restaurants in IL, IA, IN, WI, MI, OH, MN, NE, SD, MT, ND, KY, WV, and MO. The company has since reported that it has replaced the supplier of salads in those states. More information can be found in McDonald’s Statement.

Consumers who have symptoms of cyclosporiasis should contact their health care provider to report their symptoms and receive care. Most people infected with Cyclospora develop diarrhea, with frequent, sometimes explosive, bowel movements. Other common symptoms include loss of appetite, weight loss, stomach cramps/pain, bloating, increased gas, nausea, and fatigue. Vomiting, body aches, headache, fever, and other flu-like symptoms may be noted. Some people who are infected with Cyclospora do not have any symptoms. If not treated, the illness may last from a few days to a month or longer. Symptoms may seem to go away and then return one or more times (relapse).

Pepperidge Farm has been notified by one of its ingredient suppliers that whey powder in a seasoning that is applied to four varieties of crackers has been the subject of a recall by the whey powder manufacturer due to the potential presence of Salmonella. Pepperidge Farm initiated an investigation and, out of an abundance of caution, is voluntarily recalling four varieties of Goldfish crackers. The products were distributed throughout the United States. No illnesses have been reported. No other Pepperidge Farm products in the U.S. are subject to this recall.

The following four varieties with the indicated codes are subject to this recall:

Flavor Blasted® Xtra Cheddar

Flavor Blasted® Sour Cream & Onion

Goldfish® Baked with Whole Grain Xtra Cheddar

Goldfish® Mix Xtra Cheddar + Pretzel

As a precautionary measure, Flowers Foods, Inc. (NYSE: FLO) is voluntarily recalling Swiss Rolls sold under the brand names Mrs. Freshley’s, Food Lion, H-E-B, Baker’s Treat, Market Square, and Great Value, distributed nationwide, and Captain John Derst’s Old Fashioned Bread distributed in Alabama, Florida, Georgia, North Carolina, and South Carolina, due to the potential presence of Salmonella in an ingredient, whey powder. The ingredient recall was initiated by a third-party whey powder manufacturer and supplier. No illnesses have been reported in connection with the recalled items. See below for list of UPC #s and “best by” dates.

Mondelēz Global LLC announced today a voluntary recall in the United States, including Puerto Rico & the U.S. Virgin Islands, of certain Ritz Cracker Sandwiches and Ritz Bits product. These products contain whey powder as an ingredient, which the whey powder supplier has recalled due to the potential presence of Salmonella.

This recall is limited exclusively to the products listed in the grid below, available at retail stores nationwide. No other Mondelēz Global LLC product is included in this recall.

Ninety people infected with the outbreak strain of Salmonella Reading have been reported from 26 states. Forty people have been hospitalized. The outbreak strain of Salmonella Reading has been identified in samples from raw turkey pet food in Minnesota, from raw turkey products from 19 slaughter and 6 processing establishments, and from live turkeys from several states.

The samples collected by FSIS at these slaughter and processing establishments were part of FSIS’ routine testing under the Salmonella performance standards. Furthermore, WGS showed that the Salmonella strain from these samples is closely related genetically to the Salmonella strain from ill people. This result provides more evidence that people in this outbreak got sick from preparing raw turkey products.

Yesterday I suggested that the FDA’s Dr. Scott Gottlieb should be a bit more transparent on who produced, processed, transported and sold the E. coli tainted romaine. Today, the FDA notes that retailers are still selling Salmonella tainted Kellogg’s Honey Smacks cereal (See below)

The FDA has become aware that recalled Kellogg’s Honey Smacks cereal are still being offered for sale. All Honey Smacks cereal was recalled in June 2018. Retailers cannot legally offer the cereal for sale and consumers should not purchase Kellogg’s Honey Smacks cereal. The FDA has learned that some retailers are still selling this product. The FDA will continue to monitor this situation closely and follow up with retailers as we become aware of recalled products being offered for sale.

As of July 12, 2018, 100 people infected with the outbreak strain of Salmonella Mbandaka have been reported from 33 states.

Illnesses started on dates from March 3, 2018, to July 2, 2018. Ill people range in age from less than one year to 95, with a median age of 57. Of ill people, 68% are female. Out of 77 people with information available, 30 (39%) have been hospitalized. No deaths have been reported.

Illnesses that occurred after June 19, 2018, might not yet be reported due to the time it takes between when a person becomes ill and when their illness is reported. This takes an average of 2 to 4 weeks.

State and local health officials continue to interview ill people and ask questions about the foods they ate and other exposures in the week before they became ill. Fifty-five (85%) of 65 people interviewed reported eating cold cereal. In interviews, 43 people specifically reported eating Kellogg’s Honey Smacks cereal. Ill people in this outbreak reported this cereal more often than any other cereals or food items.

Health officials in several states collected Kellogg’s Honey Smacks cereal from retail locations and ill people’s homes for testing. Laboratory testing identified the outbreak strain of Salmonella Mbandaka in a sample of unopened Kellogg’s Honey Smacks cereal collected from a retail location in California. Laboratory testing also identified the outbreak strain in samples of leftover Kellogg’s Honey Smacks cereal collected from the homes of ill people in Montana, New York, and Utah.

The Kellogg Company recalled all Honey Smacks products that were on the market within the cereal’s one-year shelf-life. However, Honey Smacks products with earlier dates could also potentially be contaminated. Do not eat Kellogg’s Honey Smacks cereal of any size package or with any “best if used by” date.

Dr. Gottlieb it is past time for the FDA – especially during an outbreak and recall situation – to make the supply chain transparent.

The Centers for Disease Control and Prevention (CDC) is reporting 60 cases from five states – Illinois, Indiana, Michigan, Missouri, and Ohio. The CDC investigation indicates pre-cut melons, including fruit salads, are a likely source of this multistate outbreak. SpartanNash appears to be the supplier and processor, but may be named under Renaissance or Caito Foods.

“The Illinois Department of Public Health is urging people not to eat pre-cut melon purchased from any Walmart store in Illinois, or any of the other affected states, at this time,” said IDPH Director Nirav D. Shah, M.D., J.D. “If you have recently purchased pre-cut melon from Walmart, throw it out. If you have recently eaten pre-cut melon from a Walmart store and experience diarrhea, fever, and cramps, contact your health care provider.”

Illinois cases range in age from 23 to 87 years and have been reported in all regions of the state. Therefore, it is recommended that people not eat pre-cut melon from Walmart stores anywhere in Illinois. As the investigation continues, additional grocery stores may be added.

Most people affected by Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after eating food contaminated by the bacteria. The illness usually lasts 4 to 7 days, and most people recover without treatment. However, diarrhea for some people may be so severe that they need to be hospitalized. The CDC has indicated there have been more hospitalizations with this outbreak than what is typically seen. The elderly, infants, and those with compromised immune systems are more likely to have a severe illness.

The U.S. Food and Drug Administration is working to identify the source of Salmonella and there may be recalls as more information is learned. Walmart stores in Illinois have removed pre-cut melons linked to this outbreak from their shelves.

King 5 News reports that Seattle and King County public health officials are investigating an E.coli outbreak at several Homegrown restaurants in the Seattle area.

Officials say four people have tested positive for Shiga-producing E. coli (STEC) after eating food at three different Homegrown restaurants in King County: Redmond, Kirkland, and Seattle at the Westlake Avenue location.

All four people – three adults and one child – ate the chicken pesto chicken sandwich during April 24-26, 2018. Victims suffered abdominal cramps and diarrhea, with one person reporting they had bloody diarrhea.

Health investigators inspected the three Homegrown locations and identified potential risk factors, such as handwashing facilities violations at two of three locations and a cold holding temperature violation at one of them. All three restaurants were required to complete a thorough cleaning and disinfection.

Investigators were also looking into the various ingredients of the chicken pesto sandwich. Since then, all Homegrown locations in King County have stopped selling the chicken pesto sandwich during the investigation.

According to Live Science, Kentucky Derby fans may need to take some extra precautions before heading off to the races.

The Indiana State Department of Health is recommending that its residents get vaccinated against hepatitis A and take other steps to protect themselves from the illness before traveling to Kentucky or Michigan, both of which are experiencing large outbreaks of the viral infection.

Kentucky has reported more than 300 cases of hepatitis A since November 2017, with 39 new cases reported in the first week of April, according to the Kentucky Department for Public Health. Most cases in the state have occurred around Louisville — the city where the Kentucky Derby is held. The famous horse race, which draws more than 150,000 people each year, takes place on the first Saturday in May.

I have the honor of being an invited speaker next week in Florence at the VTEC Conference. Being that is coming in the middle of what is appearing to be a terrible VTEC outbreak involving romaine lettuce, I may well have to change up my presentation.

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About Bill Marler

Bill Marler is an accomplished personal injury and products liability attorney. He began litigating foodborne illness cases in 1993, when he represented Brianne Kiner, the most seriously injured survivor of the Jack in the Box E. coli O157:H7 outbreak.